Padres que cuidan a sus hijos con plurisdiscapacidad: estudio cualitativo sobre el cuidado y sus consecuencias

Las personas con pluridiscapacidad presentan retraso mental severo o profundo además de otros déficits orgánicos, físicos o mentales. Las vidas de las familias de niños con pluridiscapacidad transcurren en un proceso de duelo continuo para adaptarse a las constantes pérdidas del menor y tienen que prestarles cuidados para hacer frente a los síntomas que les producen las distintas discapacidades que padecen. Estudio etnográfico con el objetivo de conocer las características del cuidado que prestan los progenitores a sus hijos con pluridiscapacidad. Técnicas: observación participante y entrevistas. Participantes: progenitores de hijos e hijas entre 3 y 18 años con pluridiscapacidad de Barcelona (España), reclutados a través de las escuelas de educación especial. Los resultados muestran que los padres han aprendido los cuidados que prestan a través de su propia experiencia. Expresan la influencia positiva que les produce el cuidado de sus hijos y su deseo de seguir cuidándoles. Manifiestan su malestar por no disponer de un modelo de atención integral y reclaman un profesional que actúe como su referente.

Recomendaciones para una presentación oral

Los profesionales de la salud deben ser competentes en el desarrollo de su disciplina pero además deberán ser hábiles en el manejo de las herramientas destinadas a la comunicación, cuyo uso será necesario en algún momento de su carrera profesional. El presente artículo describe algunos de los elementos que intervienen antes, durante y después de la comunicación oral y que pueden ser útiles para mejorar las habilidades personales para realizar una exposición oral. Enfrentarse a una audiencia puede producir cierta angustia y nerviosismo que es necesario controlar, la preparación de fa intervención oral y de los medios audiovisuales, así como el uso de los elementos paralingüísticos y el lenguaje del cuerpo, pueden disminuir la tensión nerviosa y aumentar el rendimiento de la exposición oral, condiciones indispensables para una exposición efectiva.

Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals

Background: As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods: This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (3742 weeks) singleton births. Results: Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions: Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.

La evolución de la financiación de las comunidades autónomas de régimen común, 2002-2011

En este trabajo se construyen series de financiación a competencias homogéneas e igual esfuerzo fiscal para las comunidades autónomas de régimen común durante el período 2002-11, así como series complementarias de financiación por caja y financiación destinada a competencias singulares. También se recopilan otros agregados de interés que pueden servir para relativizar la financiación autonómica, incluyendo la población ajustada regional. Estas series se utilizan en la segunda parte del trabajo para ilustrar algunos rasgos de interés de la evolución de la financiación agregada regional y de la posición relativa de las distintas comunidades autónomas en términos de financiación por unidad de necesidad.